Form 433-A(OIC) - April 2026 - Collection Information Statement

Sep 19, 2026

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Form 433-A(OIC) (April 2026) collects required personal, household, and employment details for individuals who owe U.S. income tax, have related excise tax liability, or are responsible for a Trust Fund Recovery Penalty. It captures information for wage earners and self-employed individuals, including spouse and household dependents. The form also requests comprehensive domestic and foreign asset data, including cash, investments, retirement accounts, and digital assets, with valuation instructions and worksheet-style totals.

LanguageEnglish

CategoryForms

FormatPDF

Pages8

Reading Time3 min

AccessFree to download

Section 1 Personal and Household Information

Marital status, addresses, and residence details

Spouse information

Household and dependents information

Section 2 Employment Information for Wage Earners

Employer details and pay periods

Spousal employment details

| Form 433-A(OIC)
(April 2026) | Department of the Treasury —Internal Revenue Service
Collection Information Statement for Wage Earners and
Self-Employed Individuals | | --- | --- | Use this form if you are ·An individual who owes income tax on a Form 1040,U.S.Individual Income Tax Return ● An individual with a personal liability for Excise Tax ·An individual responsible for a Trust Fund Recovery Penalty ● An individual who is self-employed or has self-employmentincome.You are considered to be self-employed if you are inbusiness for yourself,or operate a trade or business. Note:Include attachments if additional space is needed to respond completely to any question.This form should only be used with the FormComplete this section if you or your spouse are wage earners and receive a Form W-2.If you or your spouse have self-employment income (that is 656,Offer in Compromise. | Section 1
Personal and Household Information | | | | | | --- | --- | --- | --- | --- | | Last name | First name | Date of birth (mmddlyy) | | Social Security Number or ITIN | | | | | | | | Marital status
□Unmarried □Married
If married,date of marriage(mm/ddyyyy) | Home physical address (street,city,state,ZIP code) | | Do you
□Own your home
□Rent
□Other (specify e g.,share rent live with relative,et.) | | | | | | | | □ If you were married and lived in AZ,CA,ID,LA,NM,NV,TX,WA or WI within the last ten years check here | County of residence | Primary phone | Home mailing address (if different from above or post office box number) | | --- | --- | --- | | | | | | Secondary phone | FAX number | | | | | | Provide information about your spouse. | Spouse's last name | Spouse's first name | Date of birth (mm/ddlyyy) | Social Security Number | | --- | --- | --- | --- | | | | | | Provide information for all other persons in the household or claimed as a dependent. | Name | Age | Relationship | Claimed as a dependent
on your Form 1040 | Contributes to
household income | | --- | --- | --- | --- | --- | | | | | □Yes
No | No
Yes | | | | | No
□Yes | No
Yes | | | | | □Yes
No | No
Yes | | | | | No
□Yes | No
Yes | | Section 2
Employment Information for Wage Earners | | | | | you file a Schedule C,E,F,etc.)instead of,or in adition to wage income,you must also complete Business Information in Sections 4,5,and 6. | Your employer's name | Bi-weekly
Pay period
Weekly
□Other
Monthly | Employer's address (street,city,state,ZIP code) | | --- | --- | --- | | | | | | Do you have an ownership interest in this business
□Yes (also complete and submit Form 433-B)
□No | | | | Your occupation | How long with this employer
(months)
(years) | | | Spouse's employer's name | Pay period
Weekly
□Bi-weekly
Monthly
□Other | Employer's address (street,city,state,ZIP code) | | Does your spouse have an ownership interest in this business
□Yes (also complete and submit Form 433-B)
□No | | | | Spouse's occupation | How long with this employer
(months)
(yeas) | | | | | | ·An individual who is personally responsible for a partnershipliability (only if the partnership is submitting an offer) ·An individual who is submitting an offer on behalf of theestate of a deceased person Personal Asset Information (Domestic and Foreign) Use the most current statement for each type of account,such as checking,savings,money market and online accounts,stored value cards (such as apayrollcard from an employer),investment,retirement accouts(IRAs,Keogh,401(k)plans,stocks,bonds,mutual funds,certificates of deposit)anddigital assets,or financial interests in digital assets,such as non-fungible tokens (NFTs)and virtual curencies,such as cryptocurrencies andstablecoins,lif

FAQs

Who should use Form 433-A(OIC)?

Individuals who owe income tax on Form 1040, have personal excise tax liability, are responsible for a Trust Fund Recovery Penalty, or are self-employed (including operating a trade or business) should use this form.

What information is required in Section 1?

Section 1 requests personal and household information such as names, date of birth, Social Security number or ITIN, marital status, home and mailing addresses, and details for a spouse and household dependents.

What types of assets must be reported on the form?

Report current assets across domestic and foreign accounts, including cash and investments, retirement accounts, life insurance policies with cash value, and certain digital assets such as NFTs, cryptocurrencies, and stablecoins, with valuation and total calculations following the form’s instructions.

Sep 19, 2026

Upload by Skyler